Information

  • Document No.

  • Conducted on

  • Prepared by

Self contained room handover checklist

  • UNIT

  • Room

  • Resident moving into room

  • Resident moving out of the room

  • Resident present at time of inspection

  • Fire door condition

  • SPECIFY

  • SPECIFY

  • Carpet/Vinyl Condition

  • SPECIFY

  • Chest of drawers

  • SPECIFY

  • SPECIFY

  • Wardrobe

  • SPECIFY

  • Condition of bed

  • Condition of matress

  • Condition of bedside cabinet

  • SPECIFY

  • SPECIFY

  • Lights

  • SPECIFY

  • Heaters

  • SPECIFY

  • Condition of Walls

  • SPECIFY

  • SPECIFY

  • Condition of Ceilings

  • SPECIFY

  • SPECIFY

  • Condition of smoke detector

  • SPECIFY

  • Condition of Windows

  • SPECIFY

  • Specify

  • SPECIFY

  • Condition of Blinds / curtains

  • Specify

  • Rectify

  • Management informed?

  • MANAGEMENT INFORMED?

  • Condition of bathroom door

  • SPECIFY

  • SPECIFY

  • Condition of bathroom Sink

  • Specify

  • SPECIFY

  • Condition of Toilet

  • Specify

  • SPECIFY

  • Condition of shower enclosure

  • Shower head requires descaling

  • Condition of mirrored Bathroom cabinet

  • Cooker in good working order

  • Cooker requires cleaning

  • Condition of worktop

  • Condition of kitchen sink

  • Room cleaning

  • STAFF Signature

  • Maintenance Tech Signture

Resident Signature

  • I AM AWARE OF ITEMS ABOVE

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